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Surgical Endoscopy

, Volume 32, Issue 9, pp 4022–4028 | Cite as

Technique, safety, and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer

  • Filippo ScopellitiEmail author
  • Antonio Pea
  • Rita Conigliaro
  • Giovanni Butturini
  • Isabella Frigerio
  • Paolo Regi
  • Alessandro Giardino
  • Helga Bertani
  • Marina Paini
  • Paolo Pederzoli
  • Roberto Girelli
Dynamic Manuscript

Abstract

Background and aims

Radiofrequency ablation (RFA) is a well-recognized local ablative technique applied in the treatment of different solid tumors. Intraoperative RFA has been used for non-metastatic unresectable pancreatic ductal adenocarcinoma (PDAC), showing increased overall survival in retrospective studies. A novel RFA probe has recently been developed, allowing RFA under endoscopic ultrasound (EUS) guidance. Aim of the present study was to assess the feasibility and safety of EUS-guided RFA for unresectable PDACs.

Methods

Patients with unresectable non-metastatic PDAC were included in the study following neoadjuvant chemotherapy. EUS-guided RFA was performed using a novel monopolar 18-gauge electrode with a sharp conical 1 cm tip for energy delivery. Pre- and post-procedural clinical and radiological data were prospectively collected.

Results

Ten consecutive patients with unresectable PDAC were enrolled. The procedure was successful in all cases and no major adverse events were observed. A delineated hypodense ablated area within the tumor was observed at the 30-day CT scan in all cases.

Conclusions

EUS-guided RFA is a feasible and safe minimally invasive procedure for patients with unresectable PDAC. Further studies are warranted to demonstrate the impact of EUS-guided RFA on disease progression and overall survival.

Keywords

Pancreatic ductal adenocarcinoma Unresectable pancreatic cancer Radiofrequency ablation Endoscopic ultrasound 

Abbreviations

RFA

Radiofrequency ablation

PDAC

Pancreatic ductal adenocarcinoma

EUS

Endoscopic ultrasound

CT

Celiac trunk

SMA

Superior mesenteric artery

HA

Hepatic artery

SMV

Superior mesenteric vein

PV

Portal vein

CT

Computed tomography

MRI

Magnetic resonance imaging

Notes

Acknowledgements

We kindly thank Dr. Marzio Frazzoni for the unevaluable contribution in paper revision.

Compliance with ethical standards

Disclosures

Dr. Filippo Scopelliti, Dr. Antonio Pea, Dr. Rita Conigliaro, Dr. Giovanni Butturini, Dr. Isabella Frigerio MD, Dr. Paolo Regi, Dr. Alessandro Giardino, Dr. Helga Bertani, Dr. Marina Paini, Prof. Paolo Pederzoli, and Dr. Roberto Girelli have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MOV 74194 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Filippo Scopelliti
    • 1
    Email author
  • Antonio Pea
    • 2
  • Rita Conigliaro
    • 3
  • Giovanni Butturini
    • 1
  • Isabella Frigerio
    • 1
  • Paolo Regi
    • 1
  • Alessandro Giardino
    • 1
  • Helga Bertani
    • 3
  • Marina Paini
    • 4
  • Paolo Pederzoli
    • 1
  • Roberto Girelli
    • 1
  1. 1.Department of Hepato-Pancreato-Biliary SurgeryPederzoli HospitalPeschiera del GardaItaly
  2. 2.Department of Pancreatic SurgeryUniversity of VeronaVeronaItaly
  3. 3.Gastroenterology and Digestive Endoscopy UnitBaggiovara HospitalModenaItaly
  4. 4.Department of General SurgeryPederzoli HospitalPeschiera del GardaItaly

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